How to Read Your Explanation of Benefits (EOB)

 

What is an Explanation of Benefits?

We send you an Explanation of Benefits (EOB) statement each time we process your dental claims. The EOB shows the dental claims your dentist submitted and how we processed your claim.

Simply put, your EOB statement is an important record of your dental services and benefit coverage.

For quick, convenient and confidential access to your claims and eligibility information, sign in to My Dental Benefits to get an EOB online. It’s a good idea to keep your EOBs, in case you have questions about your claims.

 

Reading an EOB

The EOB has four major sections:

  1. Claim information: Includes the member and patient name, ID number, claim number and dentist name
  2. Service and coverage information: Identifies dates of service, charges, what was paid, discounts, deductions and any uncovered expenses
  3. Explanations: Provides additional information for the sections described above. For example, if a claim is not paid in full, the EOB notes what benefit limitations or exclusions apply.
  4. Patient summary: Details the benefit period, amount applied to the individual program dollar maximum and group number

See a sample EOB PDF icon

 

Other resources

Learn how your dental plan works

Get state-specific rules about your plan

Contact customer service

Download claim forms